Exposure to birch pollen in infancy and development of atopic disease in childhood
Exposure to birch pollen in infancy and development of atopic disease in childhood
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DOI：
10.1067/mai.2002.125829
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发表时间：
2002-07-01
影响因子：
14.2
通讯作者：
Hedlin, G
中科院分区：
文献类型：
--
作者：
Kihlström, A;Lilja, G;Hedlin, G
背景：早期过敏原暴露、致敏和特应性疾病发展之间的关系仍有争议。1993年在瑞典的斯德哥尔摩，Acre记录了极高水平的桦树花粉，这为研究婴儿期不同暴露的儿童创造了独特的机会。目的：我们试图评估早期高剂量暴露于吸入性过敏原的影响（桦树花粉）对儿童过敏性疾病的致敏和发展的影响。对1992年、1993年或1994年2月至4月在斯德哥尔摩出生的583名4.5岁至5岁的特应性遗传儿童进行了调查。这些儿童接受了检查，并接受了吸入性和食物过敏原的皮肤点刺试验。抗桦树花粉和重组桦树花粉过敏原的IgE抗体（RAST）结果：1993年出生的儿童中，（0-3个月高剂量暴露）更常致敏（即皮肤点刺试验阳性反应）对桦树花粉的敏感度高于1994年出生的儿童（低剂量暴露;分别为17.8%和8.8%，比值比[OR]，2.4; 95% CI，1.2-4.6）。在1992年出生的儿童中也观察到了相同的趋势（12-15个月时的高剂量接触; OR，1.7; 95% CI，0.9-3.2）。RAST分析结果支持。支气管哮喘、过敏性鼻结膜炎和特应性皮炎的患病率在出生年份组之间没有差异。然而，1993年出生的儿童中花粉和动物粉尘诱发的过敏性哮喘的患病率增加（OR，2.6; 95%CI，1.25.6）。早期高剂量暴露于桦树花粉和猫在家庭之间的相互作用，建议对猫的致敏性（P = 0.06）。结论：暴露于高水平的桦树花粉在婴儿期增加致敏的风险相同的过敏原，以及过敏性哮喘的风险。
Background: The relationship between early allergen exposure, sensitization, and development of atopic disease remains controversial. In 1993. extremely high levels of birch pollen,Acre recorded in Stockholm, Sweden, creating the unique opportunity to study children with different exposures during infancy.Objective: We sought to assess the influence of early high-dose exposure to an inhalant allergen (birch pollen) on sensitization and development of atopic disease in children.Methods: A total of 583 children with atopic heredity born in Stockholm in February through April 1992, 1993, or 1994 were investigated at age 4.5 to 5 years. The children were examined and underwent skin prick testing with inhalant and food allergens. IgE antibodies (RAST) against birch pollen and recombinant birch pollen allergen (rBet v 1) were analyzed in serum.Results: The children born in 1993 (high-dose exposure at 0-3 months) were more often sensitized (ie, positive skin prick test response) to birch pollen than the children born in 1994 (low-dose exposure; 17.8% and 8.8%, respectively, odds ratio [OR], 2.4; 95% Cl, 1.2-4.6). A tendency in the same direction was seen for children born in 1992 (high-dose exposure at 12-15 months; OR, 1.7; 95% CI, 0.9-3.2). The results were supported by the RAST analyses. The prevalence of bronchial asthma, allergic rhinoconjunctivitis, and atopic dermatitis did not differ between the birth-year groups. However, the prevalence of pollen- and animal dander-induced allergic asthma was increased in the children born in 1993 (OR, 2.6; 95% CI, 1.25.6). An interaction between early high-dose exposure to birch pollen and cat in the household was suggested for sensitization to cat (P =.06).Conclusion: Exposure to high levels of birch pollen in infancy increases the risk of sensitization to the same allergen, as well as the risk of allergic asthma.